Does epilepsy have symptoms when it is not causing seizures?

Written by Yuan Jun Li
Neurology
Updated on November 16, 2024
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When epilepsy is not active, there are no symptoms. Patients mainly show recurrent epileptic seizures, usually lasting three to five minutes. After the seizure stops, the patient does not exhibit any symptoms or signs. Clinically, epilepsy is categorized into primary and secondary types. For primary epilepsy, if a patient experiences more than two episodes, routine use of anti-epileptic drugs is recommended. The choice of medication varies depending on the type of epilepsy. Typically, monotherapy is preferred initially. However, if monotherapy is ineffective or causes substantial side effects, a combination of two or more anti-epileptic drugs may be used to try to control the seizures. In cases of secondary epilepsy, which often has a clear cause, the primary focus is on treating the underlying condition. This includes long-term cerebrovascular diseases like cerebral hemorrhage and cerebral infarction, as well as conditions like encephalitis and brain tumors. Treatment should be tailored to the specific disease.

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Written by Liu Shi Xiang
Neurology
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Can mild epilepsy be treated?

Mild epilepsy is treatable. If the patient is experiencing their first seizure or if the seizures are infrequent, it’s generally appropriate to observe clinically and not rush to use anti-epileptic drugs. Such patients typically experience only very mild neurological symptoms during a seizure, such as limb weakness, numbness, or facial droop. However, if the patient's seizures occur frequently, it is necessary to control the symptoms with anti-epileptic medications, which often include drugs such as levetiracetam, gabapentin, sodium valproate, and lamotrigine. Patients with mild epilepsy should also work on strengthening their exercise routines, maintaining a calm mind, and getting sufficient sleep to help prevent seizures to a certain extent. If the patient's condition worsens or becomes intractable epilepsy, surgical treatment methods may be considered to control the symptoms.

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Written by Tang Bo
Neurology
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What are the clinical manifestations of epilepsy?

Epilepsy is caused by abnormal discharges of brain cells, and the symptoms and clinical manifestations vary depending on the area of discharge. Main symptoms can include sudden loss of consciousness, rigidity followed by clonic convulsions, and may also involve cyanosis or purpling of the face, tongue biting, frothing at the mouth, urinary incontinence, dilated pupils, continuing for several seconds to minutes before stopping. This condition is called a generalized tonic-clonic seizure. Some patients may also experience sudden brief loss of consciousness and interruption of ongoing actions, with a blank stare and unresponsive to calls. They may perform simple automatic actions like swallowing or chewing. Generally, there is no falling, and the patient has no memory of the episode afterwards. This type of seizure is known as an absence seizure. Additionally, some may experience rigidity and clonic convulsions in one limb or a localized area, etc.

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Written by Tang Bo
Neurology
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How is epilepsy treated?

Epilepsy treatment can be divided into the following aspects: First is etiological treatment. If epilepsy is caused by tumors or cerebrovascular diseases, surgical removal of the lesion can relieve epilepsy, but seizures often still occur, so medication must not be stopped. Secondly, pharmacological treatment is necessary for epilepsy induced by unclear causes or genetic metabolic diseases. Treatment involves taking and adjusting medications under medical guidance, based on different types of seizures and individual patient circumstances. Additionally, for some cases where the cause cannot be clearly identified and no epileptic foci are found, functional surgery can be performed for treatment.

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Written by Yan Xin Liang
Pediatrics
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What is childhood epilepsy?

Epilepsy is a persistent brain disease characterized by recurrent epileptic seizures, abnormal perceptions, and associated neurological, cognitive, psychological, and social issues. An epileptic seizure refers to sudden, brief symptoms and signs caused by excessive and abnormal discharges of brain neurons. Depending on the affected brain functional areas, clinical manifestations can vary, including disturbances in consciousness, motor functions, sensory abnormalities, as well as psychiatric and autonomic nervous system dysfunctions. It is important to note that epileptic seizures and epilepsy are two distinct concepts.

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Written by Yan Xin Liang
Pediatrics
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What are the symptoms of epilepsy in children?

Common symptoms of epilepsy in children generally include sudden convulsions. During a convulsion, the typical manifestations are tightly closed or staring eyes, rolled-up eyeballs, clenched teeth, twitching at the corners of the mouth, frothing at the mouth, head and neck thrown back, and repetitive flexing or rigid shaking of the limbs. Generally, these can last for a few minutes, or vary from several seconds to ten minutes. Of course, there are also focal seizures, such as twitching of one side of the body, or absence seizures. Some infantile spasms are characterized by jackknife movements, occurring in clusters, with each display being different. The symptoms described earlier are typical of a generalized tonic-clonic seizure.